A febrile tourist with dehydration

Often someone waiting in the local hospital’s emergency department will catch your eye while you are working your regular shift there as a GP. This time it is a group of women, some young, others middle aged or older, sitting in triage obviously waiting for one of them to get an examination bed.

A while later the short triage note on your computer screen indicates your next patient is a 63-year-old woman from New Zealand who has had high fevers. There are no other clues. She has been categorised as triage category 2 and, although there is no distress, she is noted to have a temperature over 40^oC. You walk down to the triage cubicle and introduce yourself to the group you had noticed earlier. The atmosphere in the group is more what you would expect of girls having a good time out than being in a hospital emergency department.